HITSP Manage Sharing of Documents Transaction Package

This HITSP Transaction Package supports the sharing of patient records in the form of source attested objects called documents. A healthcare document is a composite of structured and coded health information, both narrative and tabular, that describes acts, observations and services for the purpose of exchange. No assumption is made by this construct in terms of the format and structure of the content of documents shared. Interoperability related to document content is addressed by HITSP in other constructs.

Documents may be shared within a community where a significant part of the document sharing for a consumer or patient may occur, as well as across communities. This construct addresses both the Intra-Community and the Cross-Community sharing of documents. In Cross-Community interoperability communities interconnecting their edge systems or enterprises in other ways than defined by this construct are also supported, as shown in Figure 1-1.

This HITSP construct supports the choice of one or more of the following implementation options:

XDS.a Option: Management of Document Sharing within a community according to IHE XDS.a

XDS.b Option: Management of Document Sharing within a community according to IHE XDS.b

- This is an evolution of XDS which is functionally equivalent to XDS.a but which supports the most recent Web Services standards. This enables the support of Entity Identity Assertion on all transactions, simplifies implementation and is consistent with Cross-Community Access (XCA) (see Change History Note 2)

- This addresses the requirement for federating two or more communities using IHE XDS.b internally or other non-HITSP legacy means of communication (see Change History Note 2)

Each HITSP Interoperability Specification that requires the HITSP Manage Sharing of Documents Transaction Package specifies which option(s) are required. Support of both XDS.a and XDS.b as options within this version preserves full compatibility with previous versions of this specification, while allowing new implementations to take advantage of XDS.b. XDS.a and XDS.b are functionally identical and transition from one to the other. It is the intention of HITSP to select the XDS.b option for Intra-Community interoperability in new Interoperability Specifications and in major updates to current Interoperability Specifications; support of XDS.a will be phased out over time. Migration strategies are discussed in the IHE IT Infrastructure Technical Framework XDS.b Supplement (Section 10.7).

1.2 Copyright Permissions

2009 ANSI. This material may be copied without permission from ANSI only if and to the extent that the text is not altered in any fashion and ANSIs copyright is clearly noted.

IHE materials used in this document have been extracted from relevant copyrighted materials with permission of Integrating the Healthcare Enterprise (IHE) International. Copies of this standard may be retrieved from the IHE Web Site at www.ihe.net.

1.3 Reference Documents

This section provides a list of key reference documents and background material. If you are already familiar with this information, proceed to Section 2.0.

A list of key reference documents and background material is provided in the table below. These documents can be retrieved from www.hitsp.org.

Reference Document	Document Description
HITSP Acronyms List	Lists and defines the acronyms used in this document
HITSP Glossary	Provides definitions for relevant terms used by HITSP documents
TN900 - Security and Privacy	TN900 is a reference document that provides the overall context for use of the HITSP Security and Privacy constructs

1.4 Conformance

This section describes the conformance criteria, which are objective statements of requirements that can be used to determine if a specific behavior, function, interface or code set has been implemented correctly.

1.4.1 Conformance Criteria

Claims of conformance may only be made for the overall HITSP Interoperability Specification or Capability with which this construct is associated.

1.4.2 Conformance Scoping, Subsetting and Options

A HITSP Interoperability Specification must be implemented in its entirety for an implementation to claim conformance to the specification. HITSP may define the permissibility for interface scoping, subsetting or implementation options by which the specification may be implemented in a limited manner. Such scoping, subsetting and options may extend to associated constructs, such as this construct. This construct must implement all requirements within the selected scope, subset or options as defined in the associated Interoperability Specification to claim conformance. This construct defines the following options that may be selected by the referencing HITSP Interoperability Specification.

1.4.2.1 Intra-Community Sharing of Documents (XDS.a Option)

Within the XDS.a option, a number of options may be selected depending on the interface implemented as defined by Table 1-2.

Interface	Options	Vol & Section
Document Consumer	Verify Integrity of Document	Section 2.1.3.3
Document Registry	No options defined
Document Repository	No options defined
Document Source	Multiple Document Submission	ITI TF-1:10.2.1
	Document Life Cycle Management	ITI TF-1:10.2.2
	Folder Management	ITI TF-1:10.2.3
Document Source Interface Integrated with a Document Repository Interface	Multiple Document Submission	ITI TF-1:10.2.1
	Document Life Cycle Management	ITI TF-1:10.2.2
	Folder Management	ITI TF-1:10.2.3

1.4.2.2 Intra-Community Sharing of Documents (XDS.b Option)

Within the XDS.b option, a number of options may be selected depending on the interface implemented as defined by Table 1-3.

Interface	Options	Vol & Section
Document Consumer	Verify Integrity of Document	Section 2.1.3.3
Document Registry	No options defined
Document Repository	No options defined
Document Source	Multiple Document Submission	ITI TF-1:10.2.1
	Document Life Cycle Management	ITI TF-1:10.2.2
	Folder Management	ITI TF-1:10.2.3
Document Source Interface Integrated with a Document Repository Interface	Multiple Document Submission	ITI TF-1:10.2.1
	Document Life Cycle Management	ITI TF-1:10.2.2
	Folder Management	ITI TF-1:10.2.3

1.4.2.3 Cross-Community Sharing of Documents (XCA Option)

Within the XCA option, a number of options may be selected depending on the interface implemented as defined by Table 1-4.

Interface	Options	Vol & Section
Initiating Gateway	XDS Affinity Domain Option	ITI TF-1:18.2.1
Responding Gateway	No options defined	- -

1.0 INTRODUCTION

1.1 Overview